Provider Demographics
NPI:1184055196
Name:HAINLINE, SAMANTHA (ATC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:HAINLINE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 ARROWHEAD DR
Mailing Address - Street 2:APT 3B
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5189
Mailing Address - Country:US
Mailing Address - Phone:309-502-9117
Mailing Address - Fax:
Practice Address - Street 1:2055 ARROWHEAD DR
Practice Address - Street 2:APT 3B
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5189
Practice Address - Country:US
Practice Address - Phone:309-502-9117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36002074A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer